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Anyone who suffers from migraines knows first-hand how disruptive and debilitating they can be. While some people experience warning signs that a migraine is coming on, others are caught off guard.
While we don’t have all the information about what causes a migraine, there’s a lot we do know. Let’s review some of our most asked questions.
What is a migraine?
A migraine is a type of headache (there are 150 kinds). While many people get headaches (roughly 50% of the U.S. adult population), migraines are less common, impacting 12-15% of people. They’re characterized by:
- A pulsing, throbbing or pounding headache that becomes moderate to severe
- Typically one-sided
- Light sensitivity
- Appetite decrease
- Changes in body temperature (feeling too warm or too cold)
- Blurry vision
- Nausea and vomiting
How long do they last?
Migraines typically last from 4-72 hours.
And will it happen again?
Probably. Most people who get migraines will have 2-4 per month, but it’s different for everyone.
Who is most likely to get a migraine?
Women are 3x as likely as men to experience migraines. Those who have high-stress levels, or are struggling with their sleep are also at a higher risk. And then, there is a genetic factor. If you have a relative who suffers from migraines, there’s a higher chance that you will too. While the specific genetic cause of migraines hasn’t been identified, there is a higher incidence of migraines in children of parents who suffer from them as well.
Does my cycle impact my migraines?
Possibly, yes. Hormone changes can be a trigger for migraines in women. If you notice that your migraines tend to come around the start of your period, this could be a sign that estrogen fluctuation is a factor in your migraines.
Are there any signs I can look out for that a migraine is coming on?
Migraine headaches have four stages (though not everyone goes through each stage): the prodrome, the aura, the headache, and the postdrome. In the first phase, the prodrome, you might notice:
- Mood changes
- Nausea and/or fatigue
- Muscle stiffness
- Food cravings
- Increased need to urinate
These signs can alert you that a migraine is coming on. Many people choose to take migraine medication during this stage or get extra rest to help mitigate the headache symptoms and possibly shorten the duration of the migraine.
What’s an aura?
About 25% of people who get migraines also get auras – also known as the second phase of a migraine. For those who miss the prodrome symptoms, the aura can be the sign that a migraine is approaching. Most often, an aura is visual. You might notice flashes of light, bright spots or shapes, or vision loss either in a single field of vision, or complete (temporary) loss of sight in one or both eyes.
The non-visual symptoms of the aura phase are:
- Loss of other senses like hearing or feeling
- Pins and needles sensations, burning or pain
- Weakness or numbness in your face or on a side of your body
- Difficulty speaking
- Uncontrolled jerking or movements of a body part
It is important to note that these symptoms can overlap with the symptoms of a stroke and can be very frightening. The important distinction between migraine aura and stroke is the aura symptoms resolve completely and do not have a lasting effect. Whereas a stroke causes long term and often permanent changes in function.
How do I know the migraine is over?
After the throbbing headache comes the postdrome – which looks different for everyone. Some people notice when they move their head, the area that was throbbing hurts, some experience feelings of sadness, while others feel elated. It’s also common to experience difficulty concentrating and tiredness.
What causes migraines?
Headaches are categorized as either primary headaches or secondary headaches. A primary headache means it is the sole issue and is not a symptom of a larger disease process. A secondary headache is the sign of another health issue. Migraines are primary headaches, meaning they are not a symptom of a bigger issue, they are the issue.
Here are some common causes of migraines:
- Female hormones: Women are more likely to experience migraines due to estrogen fluctuation. Migraines are closely linked with the menstrual cycle for some women.
- Stress level: Those with a generally high stress level or those who experience stressful events are more likely to have migraines.
- Lifestyle choices: Like alcohol use (particularly wine), not eating, poor sleep
- Caffeine: If you have too much caffeine, or are experiencing caffeine withdrawal, that can bring on a migraine.
- Food sensitivity: Some foods and beverages can be responsible for migraines. For example: aged cheese, alcohol, foods containing nitrates.
- Genetics: If you suffer from migraines there’s a very high chance that a relative of yours does too.
Is a migraine a sign of a larger health issue?
Not usually. Migraines themselves are the issue – they’re not typically a sign of other health issues. However, if this is new for you, it’s a good idea to check in with your provider as they can properly diagnose you and you can discuss treatment options to minimize your suffering.
How to make a migraine go away?
The first step is to notice what’s causing your migraines. If you’re not sure, keep a journal and note the date/time of your migraine with a detailed overview of your symptoms and other factors. You can find a great list of questions to ask yourself here. That said, for some people it’s not possible to identify a consistent trigger. In either case, getting some sleep, avoiding loud and bright environments, and staying hydrated can help to ease your symptoms.
There are many types of migraine medications. They fall into two categories: preventive medications and abortive. Preventive options are prescribed to those with severe migraines and can be taken daily to ward off migraines. Abortive options are used to treat the migraine at the first sign of it.
Talk to your provider about your specific symptoms and they’ll be able to help you come up with a treatment plan, which might include medication and/or lifestyle changes.
Reviewed by the Ovia Health Clinical Team
- “Migraine Headaches: Causes, Treatment & Symptoms.” Cleveland Clinic, https://my.clevelandclinic.org/health/diseases/5005-migraine-headaches.
- “Migraine.” Mayo Clinic, Mayo Foundation for Medical Education and Research. July 2, 2021. https://www.mayoclinic.org/diseases-conditions/migraine-headache/symptoms-causes/syc-20360201.
- “How a Migraine Happens.” Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/headache/how-a-migraine-happens.
- Cutrer, MD, Michael. “Pathophysiology, Clinical Manifestations, and Diagnosis of Migraine in Adults.” UpToDate, UpToDate. November 5, 2020. https://www.uptodate.com/contents/pathophysiology-clinical-manifestations-and-diagnosis-of-migraine-in-adults.